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Target Concepts:
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Query: UMLS:C0023890 (
cirrhosis
)
42,195
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Tuberculous peritonitis is an uncommon disorder and is often not considered on initial evaluation of ascites. A negative 5-TU
PPD
test, a normal chest roentgenogram, or a low level of ascitic fluid protein may erroneously direct attention away from tuberculosis. Failure to thoroughly evaluate nonmalignant exudative ascites, especially in alcoholics, is a common diagnostic pitfall. TB peritonitis should be considered in the differential diagnosis in every patient who presents with ascites, fever, and abdominal pain, particularly when alcoholism, a lung lesion, weight loss, or
cirrhosis
is also present. Percutaneous needle biopsy of peritoneum, followed by peritoneoscopy if necessary, may preclude the need for laparotomy. Antituberculous drugs, when conscientiously taken, afford a rapid response with a cure in most patients. Case material on four patients is presented.
...
PMID:Tuberculous peritonitis. 51 68
In 19 patients with Wilson's disease we found an increased humoral immune response, i.e. a higher level of IgG and IgM, a higher titre of antibodies against Kunin's CA antigen and a depressed cell-mediated immunity i.e. a lower response to DNCB and E. coli in skin tests, lower lymphocyte transformation when stimulated by Con A,
PPD
, Candida albicans and streptokinase and a lower production of macrophage migration inhibition factor. The changes observed in the group of patients with
liver cirrhosis
caused by other facotrs than Wilson's disease were similar but less pronounced. We also found that leukocytes of patients with Wilson's disease have an impaired bactericidal activity and that copper ions have an inhibitory effect on some tests for cell-mediated immunity. It seems probable that immunological abnormalities in Wilson's disease are caused by
liver cirrhosis
but we cannot exclude an inhibitory effect of copper ions upon the immune response and an associated effect upon leukocyte metabolism.
...
PMID:Immunological observations on patients with Wilson's disease. 97 18
From 1972 to 1989, 20 cases of tuberculous peritonitis were seen in Tokyo Metropolitan Geriatric Hospital. In 13 patients the diagnosis of tuberculous peritonitis was made only at autopsy, which in 7 patients was made during life. Of all 20 cases the mean age was 78 years, with a range of 63 to 96 years. There were no differences in mean ages between autopsied patients and clinically diagnosed patients. There were 11 male and 9 female patients. In autopsied patients 6 were male and 7 were female. Of the clinically diagnosed patients 5 were male and 2 were female. Seven of 13 patients who were diagnosed at autopsy had liver diseases, for example liver fibrosis,
liver cirrhosis
, hepatocellular carcinoma or chronic hepatitis. In 4 of 7 patients who were diagnosed during life, ileus was also present and their diagnosis of tuberculous peritonitis was made at operation. Only 6 patients had tuberculin test with intermediate strength
PPD
. There were no positive reactions. In patients who were diagnosed during life, abdominal swelling, anorexia, abdominal pain and fever, the most common clinical manifestations, were seen in 100%, 75%, 50% and 86%, respectively. In contrast, they were seen in 33%, 57%, 0% and 62%, respectively, in autopsied patients. The volume of ascitic fluid varied from zero to 3000 cc. Total white-cell count in the peripheral blood was within or lower than the normal range in 85% of all 20 cases. The lymphocytes count in the peripheral blood was decreased in 95% of all 20 cases. There were no characteristic features in the serum biochemical analysis.(ABSTRACT TRUNCATED AT 250 WORDS)
...
PMID:[Clinical and pathological features of tuberculous peritonitis in the elderly]. 207 56
Immunological analysis of ascitic fluids from 49 patients with gastrointestinal cancer was performed and compared to those from 13 patients with
hepatic cirrhosis
and 3 with congestive heart failure. The analysis of ascitic fluid was performed using natural killer (NK) activity, MLR, PHA-induced lymphoproliferation (LP) and
PPD
-LP. Immunologic suppression by malignant ascitic fluid was more remarkably observed in PHA-LP,
PPD
-LP, MLR and NK assay than that by cirrhotic ascites, and it was further proved to be dose dependent. Ascitic fluids from patients with congestive heart failure showed no suppressive effects. There was no correlation between these suppressions and AFP, CEA or immunosuppressive acidic protein (IAP) levels in ascitic fluids. The first fraction of sephadex G 200 Gel filtration, which has a molecular weight of more than 200,000, showed the immunosuppressive activity. It is concluded from these results that this immunosuppressive factor does not involve AFP, CEA and IAP. Thus, it is presumed that the prognosis of the patients with gastrointestinal cancer might correlate with the immunosuppressive factor in their ascitic fluid.
...
PMID:[Suppression of immunological response by ascitic fluid from gastrointestinal cancer patients]. 620 9
We report 14 patients with tuberculous peritonitis presenting as persistent and exudative ascites. We found a primary site of tuberculous infection in only 10% of the patients.
PPD
test was positive in 9 patients. Ascitic fluid showed a protein content in excess of 3.5 g/dl. and more than 300 cells/mm3, mainly lymphocytes, in all patients, Ziehl stain and the culture for Tb. bacilli were negative in all cases. The confirmatory diagnosis was made by laparoscopy and peritoneal biopsy. Good views were obtained on all occasions, and there was no morbidity. Appearances were similar in all cases. Multiple white tubercles were scattered over the parietal and visceral peritoneum. filmy adhesions were present. Four patients had cirrhotic liver disease confirmed by laparoscopy. The biopsy specimen showed caseating granulomata, and the auramine stain was positive in four cases. We conclude that laparoscopy and biopsy is a safe and effective method of obtaining an early diagnosis in patients with tuberculous ascites, especially if they also have
cirrhosis
.
...
PMID:Laparoscopic diagnosis of tuberculous ascites. 621 90
40 patients with benign paraproteinemia have been studied in relation to their age and associated diseases. Significantly high frequency of liver diseases (CALD,
cirrhosis
, hepatoma, metastases) has been found (12 over 40 people) and increased incidence of idiopathic paraproteinaemia in the old age has been confirmed. 9 patients have been followed for 5 years, so that one could be sure that they had really benign paraproteinaemia: these patients have been then studied from an immunological point of view, in vivo by means of skin tests (
PPD
, Candida, Trichophyton, DNCB) and in vitro by searching for circulating immune complexes (using a new highly specific immuno-enzymatic method), and compared to controls without paraproteinaemia. Highly positive skin tests have been found only in 7 over 9 patients (even in old subjects) and 6 of them had circulating immune complexes (C.I.C.) in their sera; all the controls were negative both for skin tests and for C.I.C. Immune complexes have been found also in some cases of idiopathic paraproteinaemia, so that they do not seem to be in relation to the associated diseases. The Authors suggest that a genetically determined defect in regulator/suppressor T lymphocyte activity may cause the growth of a benign B cell neoplasm; and that monoclonal immunoglobulins most probably have antibody specificity and are directed against target antigens.
...
PMID:[Benign monoclonal gammopathies: probable antibody specificity of monoclonal immunoglobulins]. 664 78